A Futurist’s Take on Tracking Improvements in the Health System

In the end, isn’t the safety net all about helping people lead productive lives?

If so, then why measure results with lab tests, such as cheering reduced blood sugar levels in a chronically ill diabetic? Wouldn’t it be better to track how many hard-to-serve patients stay healthy enough to get and maintain jobs?

That observation came from Jonathan Peck (pictured left during a meeting in Kansas City), a senior futurist and president of the Institute for Alternative Futures (IAF) in Alexandria, Va. The thought occurred to him last week after appearances in Kansas City, Mo., and St. Louis, he said.

Officials with the Missouri Medical Home Collaborative, a public-private partnership, brought Peck to the state as they concluded a pilot project designed to better integrate medical care and behavioral health services for Medicaid patients.

I was interested in what he had to say, so I followed up by phone on Monday. Much of our discussion centered around one of the key topics in his talk to members of the Missouri collaborative: Big Data.

In general, the term describes the ability we have to analyze (and act upon) massive amounts of information stored in powerful computers.

What that means in the medical world is that researchers, practitioners, and others can measure treatment outcomes as never before.

IAF discusses the potential long-term benefits of this revolution in Scenarios of Health and Health Care in 2032, compiled in collaboration with the Robert Wood Johnson Foundation after a two-day forum in Kansas City last year.

Our discussion on Big Data flowed from my inquiry as to just how far we can take this reliance on bits and bytes to objectively measure outcomes that are potentially very subjective.

For instance, how does one account for patients’ home environment when scoring hospitals on their 30-day readmission rate? I’ll get to his answer to that one in a minute.

But, it was in ruminating on that question that he brought up his big takeaway from the sessions in Kansas City and St. Louis. And here is how he got from Point A to Point B:

One of the most fascinating outcomes for him was how many agency workers said that the emphasis on wellness for the patients actually spurred staff to lose weight, exercise, and quit smoking.

So, he thought, isn’t producing healthy, productive workers really the best overall measure of projects like the Missouri Medical Home Collaborative?

Further burnishing that thought, he said, was the discussion in St. Louis about how the workforce emphasis could spur safety-net donations from wealthy business owners.

Now, as far as my question about the limitations of Big Data, he basically said that humans are getting better and better at addressing subjective factors through data analysis.

As examples, he pointed to some of the winners of the Robert Wood Johnson Foundation’s inaugural Young Leader Awards.

Data does have limitations, he said.

Number crunching provides “a much fuller picture of any given phenomenon,” he said, “but that never means you have a purely objective view of the universe.”